As is known, carcinoma of the uterine cervix (CUC) is the second most frequent gynaecological tumour in industrialised countries and the main cause of death in the female population in developing countries.
Despite the possibility of effective secondary prevention (pap test), tumours of the uterine cervix are the cause of around 4800 deaths every year in the United States, while in Italy around 3700 new cases and 1700 deaths are recorded every year.
Surgery represents the treatment of choice in the initial stages of the disease, that is to say when the tumour is confined to the neck of the uterus. In these stages, surgery can be followed by post-operative treatment based on various prognostic factors such as the dimensions of the tumour and the presence of any lymph node metastases.
In the more advanced stages, radiotherapy combined with appropriate chemotherapy is currently considered as the standard treatment.
Pre-operative (or neoadjuvant) chemotherapy for the treatment of locally advanced carcinoma of the cervix has two different objectives:                a) to reduce the local extent of the disease in order to allow surgery which would not otherwise be possible;        b) to cure any neoplastic emboli which have spread from the tumour to parts of the body remote from the primary tumour.        
Recent meta-analyses of the randomized studies published to date on neoadjuvant chemotherapy have demonstrated a significant therapeutic benefit of this treatment, with a reduction in mortality risk of 36%.
In almost all the studies published so far, the drugs are administered intravenously and only in some studies intra-arterially. Intravenous administration of drugs leads to the onset of toxic systemic effects which differ according to the drugs used.
The main drugs that have proved to be effective in the treatment of CUC are as follows in decreasing order of importance (the main toxic effects are indicated in brackets):                Cisplatin (nausea, vomiting, nephrotoxicity, neurotoxicity, myelotoxicity);        Taxol (nausea, vomiting, alopecia, myelotoxicity);        Ifosfamide (nausea, vomiting, myelotoxicity, nephrotoxicity);        Topotecan (nausea, vomiting, myelotoxicity);        Carboplatin (nausea, vomiting, myelotoxicity);        Adriamycin (nausea, vomiting, alopecia, cardiotoxicity);        Irinotecan (nausea, vomiting, gastrointestinal toxicity, myelotoxicity);        Gemcitabine (nausea, vomiting, myelotoxicity);        Bleomycin (nausea, vomiting, cutaneous toxicity, pulmonary fibrosis).        
It has been demonstrated that systemic (intravenous) administration of these drugs causes the side effects described above.